Risk of diabetes in combined metabolic abnormalities and body mass index categories

Obesogenic diet and metabolic syndrome among adolescents in India: data-driven cluster analysis

BACKGROUND

Metabolic syndrome is on the rise in India and is primarily linked to obesogenic dietary habits. The synergy of both is a prominent risk factor for cardiovascular diseases (CVDs). Hence, the present study aims to unveil clusters at high risk of metabolic syndrome and ascertain cluster characteristics based on dietary patterns among adolescents aged 10-19 years.

DATA AND METHODS

The study utilizes secondary data, i.e., Comprehensive National Nutrition Survey conducted in 2016-18. The study sample includes children and adolescents aged 10-19 years. An unsupervised learning algorithm was used to ascertain possible clusters in the data based on individuals' dietary patterns. The k-means were used to cluster the data according to their dietary patterns. To determine the number of clusters elbow method was used, and appropriate validation indices were also obtained for the final k. Further, to ascertain the distribution of the obesogenic dietary patterns and metabolic conditions in each cluster was analysed. Bivariate descriptive analysis was used to draw further inferences.

RESULTS

The k-means clusters identified five optimum clusters based on 12,318 adolescents (6333 males (mean age:14.2 ± 2.8) and 5985 females (mean age:14.3 ± 2.8)) 17 dietary patterns. Clusters were named based on how prudent these were in terms of consuming a healthy diet. Cluster phenotypic characteristics were defined as follows: a cluster of obesogenic diets (24%) constituted the highest proportion of the total sample and was significantly suffering from obesity (p < 0.001), and greater proportions of lipid anomalies (p = 0.51) and hypertension (p = 0.44) but not statistically significant. In contrast, 21% of the sample comprised a plant-based diet cluster and suffered from all deficiencies but folate (p = 0.625), zinc (p = 0.132), and greater proportion from obesity (p = 0.19; not significant), and diabetes (p < 0.001). A cluster of "convenient" (20%) mainly suffered from lipid anomalies (p = 0.00), diabetes (p = 0.03), and a greater proportion from hypertension (p = 0.56) with deficiencies of all the essential vitamins and minerals but significantly from vitamin A (p < 0.001), folate (p < 0.001), and iron (p = 0.017). Lastly, the cluster of those who follow a "Western diet" (17%) was found to have lipid anomalies (p = 0.003), diabetes (p = 0.016), greater proportion of vitamin B12 (p = 0.136), D (p = 0.002), folate (p < 0.001), and iron deficiencies (p = 0.013).

CONCLUSIONS AND RELEVANCE

Adolescents in India show a strong association between obesogenic diet and metabolic syndrome. Therefore, the burden of metabolic syndrome at early ages can be prevented by controlling obesogenic dietary practices and addressing micronutrient deficiencies. This may be done by targeted health promotional campaigns in schools and college-going populations in India.

The Relationship between Alcohol Consumption and Incidence of Glycometabolic Abnormality in Middle-Aged and Elderly Chinese Men

Aim. The relationship between alcohol consumption and glycometabolic abnormality is controversial, especially in different ethnic population. In this study, a cross-sectional survey was carried out to examine the relationship between alcohol consumption and glycometabolic abnormality in middle-aged and elderly Chinese men. Methods. Using cluster random sampling, Chinese men aged more than 40 years from Changchun, China, were given standardized questionnaires. In total, 1996 individuals, for whom complete data was available, were recruited into the study. We calculated the incidence of prediabetes and newly diagnosed diabetes by three levels of alcohol consumption: light, moderate, and heavy. Multivariate logistic regression models adjusted for socioeconomic variables and diabetes-related risk factors were used to analyze the association between alcohol consumption and the onset of prediabetes and diabetes. Results. The univariate analysis revealed higher incidence of prediabetes among drinkers (32.8%) compared with nondrinkers (28.6%), particularly in heavy alcohol consumers. The logistic regression analysis showed that alcohol consumption, especially heavy consumption, was an independent risk factor for prediabetes. Conclusions. Alcohol consumption, heavy consumption in particular, is an independent risk factor for the development of prediabetes, but not for diabetes.